Apr 19, 2026
Effects of Film-Based Music Therapy With LLM-Generated Culturally Adapted Verbal Suggestions on Anxiety, Affect, and Heart Rate Among Chinese Young Adults: A Randomized Controlled Trial
- Wen Li1
- 1Aba Teachers College
- Wen Li: Universiti Sains Malaysia
- coco840
Protocol Citation: Wen Li 2026. Effects of Film-Based Music Therapy With LLM-Generated Culturally Adapted Verbal Suggestions on Anxiety, Affect, and Heart Rate Among Chinese Young Adults: A Randomized Controlled Trial. protocols.io https://dx.doi.org/10.17504/protocols.io.eq2lyoreegx9/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: Working
We use this protocol and it's working
Created: April 19, 2026
Last Modified: April 19, 2026
Protocol Integer ID: 315347
Keywords: Music therapy, Verbal suggestions, Artificial intelligence, Large language models, Cultural adaptation, Eastern aesthetic imagery, University students, Heart rate variability, verbal guidance during music listening, music therapy, based music therapy, music without any verbal guidance, music experience, effects of music, music with standard relaxation guidance, relaxing music, music therapy with llm, music session, verbal suggestions on anxiety, relaxation in young adult, music listening, anxiety, music, single music listening session, levels of anxiety, addition to music, verbal guidance, adapted verbal guidance, heart rate among chinese young adult, different types of verbal guidance, relaxation, verbal suggestion, based relaxation, standard relaxation guidance, chinese young adult, stress, study, randomized controlled trial this study, guidance, negative emotion, affect, effects of film, high levels of stress, being in young adult, effect
Funders Acknowledgements:
Aba Teachers College Scientific Research Innovation Team Fund
Grant ID: AS-KCTD2026-18
Abstract
This study aims to examine whether music-based relaxation combined with different types of verbal guidance can help reduce anxiety and improve emotional well-being in young adults.
University students often experience high levels of stress related to academic demands and daily life. Music listening is commonly used as a simple and safe method to promote relaxation. In addition to music itself, verbal guidance during music listening may influence how individuals imagine, interpret, and emotionally respond to the music experience.
In this study, participants are randomly assigned to one of three groups. One group listens to music accompanied by verbal guidance generated by a large language model and designed to reflect Eastern aesthetic imagery. A second group listens to music with standard relaxation guidance commonly used in music therapy. A third group listens to relaxing music without any verbal guidance. Each participant takes part in a single music listening session lasting approximately 25–30 minutes.
Levels of anxiety, positive and negative emotions, and heart rate are measured before and after the music session. By comparing the results across the three groups, this study seeks to better understand whether culturally adapted verbal guidance can enhance the effects of music-based relaxation in young adults.
Safety warnings
• Self-reported cardiovascular conditions or other medical conditions that could affect heart rate measurements.
• Participation in other psychological or behavioral intervention studies within the past 30 days.
Ethics statement
Human Subjects Review: Board Status: Approved
Approval Number: USM/JEPeM/22120811
Board Name: Human Research Ethics Committee (JEPeM)
Board Affiliation: Universiti Sains Malaysia
Study Description
Eligible university students are recruited and randomly assigned in equal numbers to one of three parallel groups: (1) a music intervention with verbal guidance generated by a large language model and designed to evoke Eastern aesthetic imagery; (2) a standard music therapy condition that includes conventional relaxation-oriented verbal suggestions; and (3) a music-only relaxation condition without verbal guidance. Randomization is conducted using a simple random allocation procedure.
All participants complete baseline assessments prior to the intervention. Each participant then takes part in a single music listening session lasting approximately 25–30 minutes in a quiet classroom setting. During the session, participants are seated comfortably with eyes closed and instructed to listen attentively to the music. Verbal guidance, when present, is delivered by a researcher during the music session.
Primary and secondary outcomes are assessed immediately before and after the intervention. Anxiety is measured using a standardized self-report anxiety scale. Emotional states are assessed using validated measures of positive and negative affect. Heart rate is recorded as an objective physiological indicator of autonomic arousal using a smartphone-based photoplethysmography method.
Arms and Interventions
Participants assigned to the Eastern Imagery Music Therapy Group listen to a curated music program accompanied by verbal guidance generated by a large language model. The verbal guidance is designed to evoke Eastern aesthetic imagery and is delivered during a single 25–30 minute music listening session.
Participants assigned to the Standard Music Therapy Group listen to music accompanied by standard relaxation-oriented verbal guidance commonly used in music therapy practice. The intervention is delivered during a single 25–30 minute music listening session.
Participants assigned to the Music-Only Relaxation Group listen to relaxing music without any verbal guidance during a single 25–30 minute session.
Outcome Measures
Primary Outcome Measure: Change in State Anxiety Score. State anxiety is assessed using the State subscale of the State–Trait Anxiety Inventory (STAI-S), a validated self-report questionnaire consisting of 20 items. Scores range from 20 to 80, with higher scores indicating greater state anxiety. The primary outcome is the change in STAI-S score from before to immediately after the intervention. [Time Frame: Immediately before and immediately after the single 25-30 minute music listening session]
Secondary Outcome Measure: Change in Positive Affect Score. Positive affect is measured using the Positive Affect subscale of the Positive and Negative Affect Schedule (PANAS). The subscale consists of 10 items assessing positive emotional states, with higher scores indicating greater positive affect. The outcome is defined as the change in positive affect score from before to immediately after the intervention. [Time Frame: Immediately before and immediately after the single 25-30 minute music listening session]
Secondary Outcome Measure: Change in Negative Affect Score. Negative affect is measured using the Negative Affect subscale of the Positive and Negative Affect Schedule (PANAS). The subscale consists of 10 items assessing negative emotional states, with higher scores indicating greater negative affect. The outcome is defined as the change in negative affect score from before to immediately after the intervention. [Time Frame: Immediately before and immediately after the single 25-30 minute music listening session]
Secondary Outcome Measure: Change in Heart Rate. Heart rate is recorded as an objective physiological indicator of autonomic arousal using a smartphone-based photoplethysmography method. The outcome is defined as the change in mean heart rate measured immediately before and immediately after the intervention. [Time Frame: Immediately before and immediately after the single 25-30 minute music listening session]
Acknowledgements
Contacts/Locations:
Central Contact Person: Wen Li, PhD
Telephone: +86-137-8098-8180
Email: [email protected]
Central Contact Backup:
Study Officials: Wen Li, PhD
Study Principal Investigator
Aba Teachers College
Locations: China, Sichuan
Aba Teachers College
Aba, Sichuan, China
Contact: Study Coordinator 028-62332777 [email protected]
IPDSharing:
Plan to Share IPD: Undecided